ABSTRACT: The present study sought to assess the rational use of
antimicrobial agents in a Brazilian intensive care unit (ICU) and its
association with antimicrobial resistance in elderly patients admitted to the
unit. Results: Choice of empiric and sensitivity-guided therapy was inadequate
in > 80% and 59% of cases respectively. Inadequate antimicrobial therapy,
whether empiric or sensitivity-guided, was positively correlated with bacterial
resistance (r = 0.316; p = 0.001). Sensitivity testing revealed a 46.5% resistance
rate to eight out of the ten most commonly used antibiotics. Multiple
drug-resistant organisms were found in 40.8% of patients. A significant
increase was observed in the number of multidrug-resistant samples between
2006/2007 and 2008 (r = 0.41, p = 0.006), (r = 0.598, p = 0.001), (r = 0.688, p
= 0.00). Conclusion: We found a high rate of antibiotic misuse in the study
sample. Inadequate therapy was correlated with resistance to antimicrobial
agents.